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RACISM

Opinion: The Swedish discrimination that dares not speak its name

Until Sweden addresses discrimination honestly, integration debates will remain superficial, writes journalism professor Christian Christensen, after the Dagens Nyheter newspaper exposed how medical staff allow patients to pick only 'ethnic Swedish' doctors.

Opinion: The Swedish discrimination that dares not speak its name
An article by Swedish newspaper Dagens Nyheter exposed how medical staff promised patients they could get 'light-skinned' doctors to treat them. Photo: Cleis Nordfjell/SvD/TT

Few things damage the national self-image, while at the same time generating impassioned defenses of the national good, like accusations of structural discrimination.

While racism, sexism and xenophobia at the individual level are often explained away as personal failures or “exceptions that prove the rule”, evidence of clear and sustained discrimination within public and private social institutions speak to a broader and deeper acceptance of bigotry. It cannot be waived away as some random bad apples spoiling the national barrel.

Over the past few weeks, the issue of structural discrimination in Sweden has been a topic of heated debate.

Two weeks ago, police officer Nadim Ghazale spoke at length on Swedish Radio about his professional experiences. In his talk, Ghazale recounted being asked by colleagues if, because of his immigrant background, he was a “quota hire”. In other words, he was hired simply to increase diversity. Ghazale noted that being an immigrant or a woman in the Swedish police meant having to work even harder to prove yourself to white, male colleagues. And, he continued, “if you are white, Swedish, straight and male – then you are already part of the quota. Congratulations, you got the simplest route.”

The proposal that white, straight, male Swedes have an easier time professionally was met with backlash. Conservative pundits and politicians, as well as large numbers of social media users, denied the existence of structural discrimination in Sweden. Every country has racists, they argued, but the suggestion that Sweden was, and is, anything other than a largely colour-blind meritocracy is simply incorrect. One politician from the Moderate Party even tweeted that it was “white, Swedish men” who had built the nation with their “blood and sweat”. He later deleted the tweet.

Only a few days after the national debate about Ghazale’s comments, Sweden’s Dagens Nyheter newspaper published an explosive story detailing widespread structural discrimination at public and private medical and dental offices throughout Sweden. After multiple cases of patients refusing to be treated by non-white staff had been exposed, the newspaper decided to do an investigation into how such requests were handled at the national level. For the piece, journalists called local medical offices posing as patients who had just moved into the area.

In the call, the “patients” said that they wanted to have “ethnic Swedish” doctors and dentists treating them. Disturbingly, in over half of the cases where there was diversity in the available staff, medical and dental offices went along with these clearly racist requests, promising callers that they could get “ethnic Swedish” or “light-skinned” professionals to treat them, or giving them advice on how to avoid staff who did not fit their demands.

As disturbing as they are, Ghazale’s personal experiences in the police and the Dagens Nyheter story are nothing new. Back in 2018, Swedish Television did a story about the racist treatment of staff at Swedish pharmacies, and how many of the managers either refused to condemn, or openly enabled, racist comments and requests from customers. Despite these repeated stories from staff members working across multiple industries, the denial at the national level about the extent to which structural discrimination exists is marked.

Most importantly, of course, these stories point to a broad acceptance of racism and discrimination that must be confronted openly. But, these stories also speak to other key issues so often discussed in Swedish politics and society: namely “quotas” and “integration”.

One of the most common criticisms levelled against efforts to bring more diversity into Swedish organisations and businesses via hiring practices is that such efforts go against the ideal of a society based solely on “merit.” That argument, however, is based on the myth that candidates with minority backgrounds are somehow less qualified than non-minority candidates. It is also based on the myth that the professional playing fields are equal for all employees, regardless of skin colour or ethnic background.

As the Dagens Nyheter story illustrated, staff members at medical offices were literally giving potential patients advice on how to avoid non-white doctors and dentists. Under these circumstances, it is naïve to think that the professional playing field is not tilted dramatically in favour of the white doctors and dentists in those offices. And, it is equally naïve to think that such practices do not exist in many other areas of Swedish professional life.

Over and over we hear the phrase “failed integration” in relation to immigrant communities in Sweden. In most cases, however, this failure is explained as the result of poor policy, poor effort on the part of immigrants or a combination of both. Again, the stories presented in this article point to a third, under-discussed factor impacting integration: discrimination. Even when immigrants to Sweden (or their children) are well-educated and eager to enter the workplace, they face discrimination solely on the basis of their name or appearance. This reinforces the idea that, no matter what these residents and citizens do, they will never be accepted as full, equal members of Swedish society.

As Sweden approaches elections in 2022, the issues of discrimination and integration will take more and more space in public debates. Integration, most often presented as one-way, is actually a two-way street. Until the issue of structural discrimination is addressed openly and honestly, however, such debates will remain at the superficial and self-serving levels.

Christian Christensen is a professor of journalism at Stockholm University in Sweden.

Member comments

  1. It’s really hard to get into medical and dental school in Sweden, and in North America.
    But not in many foreign lands where medical school spots go to those with connections, political or otherwise, and those who pay. So, given this, it’s possible to wonder if people are requesting local doctors and dentists based on their impressions of the underlying training and qualifications – and they are using skin tone as a proxy or marker. If so, then it is possible such requests aren’t so much about race, but are perhaps more about underlying assumptions of skill and training.

    Thoughts on this possibility?

    1. “If so, then it is possible such requests aren’t so much about race, but are perhaps more about underlying assumptions of skill and training”.

      And so the reinforcement of common tropes regarding race continues. Even if true, your comment ignores the reality that there exists a Swedish Medical Association which regulates and issues licenses for medical practitioners from other countries who wish to practice in Sweden. Such an organisation would also probably take care of reports of malpractice and strike off any medical professional who did not meet standards of practice and ethics which were required for the country.

      In my home country, UK, doctors and nursing staff come from all corners of the world and in the main are valued enormously for the contribution they make to caring for patients. We are all the more better for it and many of our highest regarded surgeons are not of “White British” ethnicity. Swedish people may need time to adapt and come round but to make excuses like they have judged professionals from other countries to be less capable is a poor show that only reinforces racism.

      Those are my thoughts.

    2. There are many more objective proxies for competence (grades, certificates, university ranking, years of experience…); if a patient cannot ask for a doctor using any of those proxies, how are they allowed to use a proxy solely based on their presumptions on what is happening in foreign lands?
      In Iran for example, it is actually quite difficult to get into medical schools, there’s a central exam for the universities and only ~2% of the (~500,000) participants manage to get into a medical program.

      1. Hi,

        I agree that there are other and perhaps more effective proxies, as you suggest.

        But all I’m suggesting – and I know you guys are having troubles with this – is that Swedes might not be raging racists. And that they might have other, and perhaps even reasonable, intentions when requesting a “local doctors” over foreign doctors.

        And with regards to med school admissions, you’ve named Iran as a country that where med school admissions are difficult. This might be true, and probably is true. But I could respond by naming dozens of nations where medical school admissions is a joke, and acceptance to med school is little more than recognition that you are a member of the middle class or upper classes and that you either know someone, or that your parents can pay the tuition fees.

        In fact, I know numerous Canadians and Americans who were rejected from med school Canada and the United States (they weren’t even remotely close to securing a spot), and who then attended med school abroad. Their parents could afford to pay the high international tuition fees.
        I don’t know about you – but I’m apprehensive about letting Jeff Spicolli (lead character in fast times at Ridgemont High) perform surgery. But it happens all the time.

        And with regards to proxies – I agree that the university attended is a good indicator.
        When in my home nation, for example, I will often casually ask my doctors what med school they attended. I want to know if it was a top med school, or a low-tier. But my decisions after that depend on the procedures required. If they are treating me for something minor, a small skin rash for example, I wouldn’t worry much about the answer. But if I have a serious issue, and I required something such as eye surgery or perhaps abdominal surgery, I’d like a doctor who attended a top med school. There is a reason why people make a big fuss about the Mayo clinic, Harvard Medical school, Columbia medical in New York etc. In Canada, I would look for graduates of the University of Toronto, Queens University, and of course McGill University in Montreal – top medical schools with high admission standards vs. some other universities.

        But, I should note, it is very hard for your average and every day citizen to differentiate between one foreign nation and another (iran vs. the Dominican Republic for example). And they certainly wouldn’t know the reputations of the universities in all the different countries, and the admissions policies. And with this, I again suggest that it is possible that many Swedes may sometimes use race as a proxy for something else – qualifications and skill – and that perhaps Swedes are not the big bad racists that the article and you seem to be suggesting. In fact, when taken within this context, their requests might be at least somewhat reasonable.

    3. Hi Jack,

      I agree with you, racism is not necessary an issue here. Being an immigrant myself, I am tired to hear that Swedes are racists during all these years I have lived in Sweden. Swedes have a lot of cultural and other issues that I really do not like but to call them racists is a way too much. It has become popular to blame other people when you fail than to seek what can be wrong in what you do.

      Regarding some patients’ requests to have ethnic Swedish doctors – it might be many reasons to it not necessary connected to racism. One of them is the language. My first years in Sweden were very hard like for any immigrant. I remember when I worked as personlig assistent for an old Swedish man with physical disabilities and severe health problems. My Swedish was not as fluent as it is now, he talked quietly and not that clear that I could understand everything. Very often I had to ask two or three times to repeat what he was telling to me. Myself I was afraid that if something happened to him I would not even understand what he needs and how to deal with that. Would it be right to call him racist if he asked for an ethnic Swede to take care of him? I don’t think so. It is important to understand that he also wants to feel secure with people around him and to be sure that these people understand what he needs.

      Let’s be fair, many immigrant doctors do not speak as good Swedish as it might be necessary. A couple of months ago I visited a doctor whose Swedish was ok for basic conversation but all the time I felt that she didn’t get what I was asking her as her answers were not really about my questions but something different. Moreover, sometimes I had to ask her to repeat because of her heavy accent. That moment I just wanted to go to a Swedish doctor. Strange enough for me as I even do not trust Swedish doctors because of really bad experiences in the past. I think that the Swedish health care system is very poor in competence and of low quality. Only people with minor health problems or problems that represent a “standard” case for the Swedish system can appreciate health care in Sweden. All my serious problems were just ignored here, and I had to go abroad to seek reliable medical help. I will not even mention ridiculously long queues and no possibility to choose a doctor.

      When I saw who wrote this article above… well… no wonder why we have one-sided journalism in Sweden.

  2. True, It’s hard to get into medical schools in Sweden. It is also not that easy to become a medical professional in Sweden if have a medical degree from another country. It is a long process starting with learning Swedish, clearing medical exams, working under the supervision of a senior doctor, and only then you would eventually become an independent professional who would be allowed to, for example, prescribe medicines. So basically, the immigrant doctors have to study medicine twice – first in their home country and then here in Sweden. If some people use race as a proxy for competence etc., then they clearly don’t understand what immigrant doctors have to go through to become approved professionals in Sweden. But I don’t think this is the issue in all the cases in the DN story. The author has rightly pointed out that integration is not a one-way street. All the onus is not on immigrants. It seems as if people are not even willing to accept that immigrants face discrimination in Sweden. Such attitudes are one of the reasons that the integration debate will just remain a one-sided debate without any real progress.

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EUROPEAN UNION

Should Sweden abandon a weak krona for the euro?

With the 20th anniversary of Sweden's euro referendum this month, the weak krona has revived the long dormant debate over Swedish membership. We look at why joining the single currency looks more attractive today.

Should Sweden abandon a weak krona for the euro?

The krona hitting rock bottom has reawakened a debate that had been dead for twenty years.

Hedge fund manager Christer Gardell kickstarted the debate before the New Year, when he said Sweden should abandon the krona, which was now “a shitty little currency”. In January, the Moderate Party grandee Gunnar Hökmark, chief of the Frivärld think-tank and long-term euro advocate, argued that Sweden should join.

Veteran economist Lars Calmfors, who chaired the government inquiry which in 1999 recommended that Sweden stay outside, made a similar call shortly afterwards. Carl Hammer, chief strategist at SEB, who had voted against joining in the 2003 referendum wrote in May that he, too, was now “leaning towards a ‘yes'” on euro membership. 

Now one of Sweden’s three government parties has started to campaign on the issue. The Liberal Party, long in theory in favour of euro membership, on September 4th called for a new government inquiry on joining the currency. 

“We can quite simply no longer afford to stay outside [the euro],” the party’s leader Johan Pehrson wrote in the Aftonbladet newspaper. “Let’s upgrade our EU membership from ‘basic’ to ‘premium’. Let’s bring in the euro now!'” 

Is it a hot topic? 

According to Calmfors and Hammer, the debate is raging in the circles they move in, but has yet to really spread to the general public. 

“Between 2010 and the end of last year, I don’t think I was asked even once to speak about Sweden and the euro. But now I have two or three invitations each week, and in fact six this week when we are approaching the 20th anniversary of the referendum.” 

“I see a lot of academic and business seminars on the weak krona,” Hammer agreed.

For both of them, the revival in interest has come about mainly due to the weakness of the krona, which Calmfors complained had been trading as if Sweden were a “banana republic”. And unlike during the 1999 internet crash or the 2007 financial crisis, when a drop in the krona helped bolster Sweden’s economy, this time the weak currency was causing problems. 

“Earlier it has benefitted us,” Calmfors said. “The krona depreciated and firms could gain market share. It helped stabilise output and employment,” he explained. “But this time, it’s different. Now, the depreciation of the krona counteracts the efforts of the Riksbank to get inflation down and reduce aggregate demand. So this time, it is a problem.” 

For Hammer, the weakness of the krona was more understandable, reflecting a flight to strong currencies in reaction to the war in Ukraine.

“Had we not had Ukraine, and had we not had other global issues, I think the krona would have been stronger,” he said.

Calmfors isn’t so certain about this, pointing out that the Swiss Franc, another small floating currency, has not been similarly weak. He does, however, see the invasion of Ukrainian as the second big reason why the euro debate has revived. 

“The war in Ukraine has made Swedes recalibrate our view of our position in the world,” he said. “The application for Nato membership is the most obvious evidence for this, but I think it spills over to the euro issue as well.”

Lars Calmfors, Professor Emeritus in Economics at Stockholm University. Photo: Anders Wiklund/TT

HOW HAVE THE FUNDAMENTALS CHANGED? 

1. Sweden’s government finances are much stronger

While the weak krona is the catalyst for the debate, for Calmfors, the improvement in Sweden’s government finances is a much better reason for sceptics to change their minds. 

When he submitted his report in 1999, his committee’s main argument against joining was the risk of a country-specific economic shock which would affect Sweden, but not other EU countries. Such a shock would be hard to combat if Sweden no longer had the freedom to set its own interest rates or devalue its currency. 

“We argued that (…) it’s good to have your own monetary policy, an exchange rate that can change,” he said. 

At that time, Sweden’s national debt was at 70-75 percent of GDP, well above the 60 percent that is the (increasingly theoretical) maximum for countries signed up to the EU’s Stability and Growth Pact.

“This was very important in the 1990s, because we had a sovereign debt crisis in Sweden, so fiscal policy could not be used as a substitute for monetary policy,” he remembered. 

Now, Sweden’s national debt is just 35 percent of GDP, well below that of France at 98 percent or Germany at 60 percent and, for Calmfors, this removes the biggest obstacle to joining, as Sweden’s government would be able to spend its way out of any country-specific shock.

“That’s very low in an international context, so we have a lot of fiscal firepower. No one would argue with us if we had an expansionary fiscal policy.” 

Hammer, arguing along the same lines, pointed out that in the years before and since the euro referendum, Sweden had never in fact suffered the sort of country-specific shock that Calmfors and his committee had worried about. The Riksbank, meanwhile, had always run a monetary policy in line with that of the European Central Bank. 

“For the past 30 years, Sweden has been living with a floating exchange rate but living as if we’ve had a fixed exchange rate,” he said. 

The country, he explained, had had strict limitations on government spending, a surplus target, a very coordinated and orderly wage bargaining process, and a fully funded pension system. “So if any country would have the room and possibility to live with a fixed exchange rate, it’s Sweden.”  

2. Businesses don’t use the krona anyway 

For Hammer, the biggest new argument against the krona is not so much improved government finances as the fact that Sweden’s big companies now barely use it.

And the same goes for Sweden’s pension funds.

“Large corporations don’t want to deal in the krona – they prefer to make transactions and trade in euros and dollars – and we channel a huge part of our surplus or excess savings into foreign asset markets,” he said. “So, we’ve already to some extent adopted foreign currencies, but we’ve also kept the krona, which from my perspective makes the arguments for having it less strong.”

It is this which has pushed him towards a “yes” despite continuing to believe that the euro is “a suboptimal currency union”.  

“I’m leaning towards voting yes if we were to have a new referendum on the basis that the foundation for the currency has been undermined by the fact that we’re so dependent on foreign currency,” he said. “From that perspective, I think, you can make a case for joining the euro on the grounds of greater financial stability.” 

3. After Brexit Sweden looks more and more alone

With the UK leaving the European Union altogether, Croatia joining the euro this year, Bulgaria scheduled to join in 2025, and Romania in 2026, the number of countries who are in the EU but not the eurozone is falling. 

“If you ask people, like Swedish commissioners in the EU or people that have been doing negotiations in in the EU, they have the view that we have lost out by not belonging to the core,” Calmfors said. “The risk that we will lose out probably becomes bigger, the greater the share of EU countries that adopt the euro.”

Carl Hammer, chief strategist at Sweden’s SEB Bank. Photo: SEB

WHAT ARE THE STRONGEST ARGUMENTS NOT TO JOIN?

1. The risk of country-specific shocks is real 

Just because Sweden has more fiscal firepower to deal with a country specific shock does not mean the risk of such shocks is not a major drawback to euro membership. 

Finland suffered one when Nokia, far and away the country’s biggest company, mismanaged its reaction to the launch of the iPhone and exited to the mobile phone business. Between 2008 and 2022 its debt to GDP ratio more than doubled from 33 percent to 74 percent. 

Greece, Italy, Spain and Portugal arguably suffered from the issue during the European banking crisis.

As Sweden’s economy is unusually sensitive to interest rates, with much higher private debt and a high share of variable rate mortgages, the ECB could easily set an interest rate that, while right for most eurozone countries, would be too high for Sweden. 

“That could be a problem, but it’s also a problem that could be dealt with by using fiscal policy,” Calmfors argues. 

2. The risk of bank bailouts and country bailouts remains 

The other big argument against joining the euro, which was clearly demonstrated during the European debt crisis from 2009 until about 2014, is that Sweden would have to help bail out countries, such as Italy and Greece, which have been less disciplined in the management of their government finances. 

Joining the euro would also mean joining the European Banking Union, which means that Sweden might also have to participate in rescuing banks in countries with less well-functioning financial supervision.

Calmfors acknowledged that this was still a risk, but argued that members of the European Union who are not part of the eurozone were increasingly being asked to contribute to rescue packages anyway. 

“If you look at the support after the Covid crisis and during the Covid crisis, we had to pay that as well, even though we were not a member of the monetary union,” he said. 

And when it came to bank bailouts, Sweden was, he argued, as likely to benefit as to lose out, given the high indebtedness of Sweden’s citizens. 

“We might end up having to pay for bank crises in other countries. But on the other hand, we would also be helped if we had a financial crisis, which of course is not something we can rule out,” he said. 

Also, he said there might be an advantage in having banks and other financial services regulated by the European Central Bank and other European regulators, as a European regulator might have more expertise, there are many cross-border links between banks, and there would be less of a risk of a cosy relationship building up between local banks and the regulator.   

HOW HAVE THE ADVANTAGES OF EURO MEMBERSHIP CHANGED?

Calmfors argues that while the negative risks of adopting the euro have diminished, the advantages remain more or less the same. 

“The biggest benefit is of course that having different currencies is a kind of trade impediment and that would be eliminated, which would mean more trade, which would mean that we use our resources more efficiently, so it would give slightly higher growth over a long period, which, even if small each year, would accumulate to quite a lot in the long term.” 

Recent research suggested, he added, that this effect might be more significant than people previously thought. 

“Studies seem to point to much bigger effects than we expected in the 1990s. We’re talking about a 10 to 20 percent increase in trade, not from one year to another, but over a number of years,” he said. 

The problem with the debate over euro membership had always been, he concluded, that the benefits and risks were of such a different character. 

“You can’t really make an economic calculation, because you are comparing different things: We are comparing small, but certain positive gains – because there will be more trade that we will get slowly over years – with a risk of big macroeconomic shocks that can have huge effects over a few years.”

This makes it hard for economists to reach a firm conclusion. 

“You can’t really say what is right and wrong, but I think what you can say is that the balance has shifted in the direction of being a more positive calculation for being a member today than there was 25 years ago.” 

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